WBR0728

Author	[[PageAuthor::Yazan Daaboul, M.D. (Reviewed by Yazan Daaboul, M.D.)]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Pharmacology
Sub Category	SubCategory::Gastrointestinal
Prompt	[[Prompt::A 48-year-old man presents to the physician's office complaining of heartburn. Following appropriate work-up, he is diagnosed with gastro-esophageal reflux disease (GERD). The patient informs the physician that he has recently been using over-the-counter aluminum hydroxide, which has been effectively relieving his symptoms. Chronic use of aluminum hydroxide is associated with which of the following conditions?]]
Answer A	AnswerA::Diarrhea
Answer A Explanation	AnswerAExp::Magnesium-based antacids are associated with diarrhea.
Answer B	AnswerB::Hyporeflexia
Answer B Explanation	AnswerBExp::Magnesium-based antacids are associated with hyporeflexia.
Answer C	AnswerC::Hemorrhoids
Answer C Explanation	AnswerCExp::Aluminum-based antacids are associated with constipation, which might predispose to hemorrhoids.
Answer D	AnswerD::Hyperkalemia
Answer D Explanation	AnswerDExp::Generally, antacids are associated with hypokalemia, not hyperkalemia.
Answer E	AnswerE::Cardiac arrest
Answer E Explanation	AnswerEExp::Although very rare, magnesium-based antacids are associated with cardiac arrest.
Right Answer	RightAnswer::C
Explanation	[[Explanation::Aluminum-based antacids, such as aluminum hydroxide, are indicated for GERD. Although they are over-the-counter medications, they are not free of side effects. In comparison to other antacids, aluminum-based antacids are known to commonly cause constipation, which might predispose to hemorrhoids. As such, physicians must be cautious in allowing patients with hemorrhoids to use aluminum-based antacids because of their potential exacerbation. Educational Objective: Aluminum hydroxide is associated with constipation, which might predispose to hemorrhoids. References: First aid 2014 page 371]]
Approved	Approved::Yes
Keyword	WBRKeyword::Antacid, WBRKeyword::Antacids, WBRKeyword::Adverse, WBRKeyword::Reaction, WBRKeyword::Adverse drug reaction, WBRKeyword::Side, WBRKeyword::Effect, WBRKeyword::Side effect, WBRKeyword::Magnesium, WBRKeyword::Aluminum hydroxide, WBRKeyword::Aluminum, WBRKeyword::Hydroxide, WBRKeyword::Hemorrhoids, WBRKeyword::Gastroesophageal reflux disease, WBRKeyword::Constipation, WBRKeyword::GERD, WBRKeyword::Gastroesophageal, WBRKeyword::Reflux, WBRKeyword::Heartburn
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::